The S&A Health Report: Your Doctor Is Lying

Imagine this scenario: Your doctor gives you a prescription and you fill it at your local pharmacy. Months later, you discover the pills just aren't working. Does this mean your doctor misdiagnosed you?

Nope.

Your doctor lied to you.

Recent results from an international survey reported more than half of all doctors in the U.S. regularly prescribe placebos to their patients. And it's not just in the U.S. It's a worldwide practice. Doctors in England, Denmark, Israel, New Zealand, and Sweden all reported using placebos, too.

Actually, this is not really news. I remember my outrage at 2003 and 2004 reports of Danish and Israeli doctors using placebos. Shamefully, the excuses then were the same now. Many times, the doctor doesn't want to give an antibiotic or pain medication, so he substitutes placebos instead.

What is a placebo you might ask? It's a Latin word that means "I will please." There is a long history in medicine of charlatans giving snake oils and concoctions to patients in the hopes of curing them. Many times, both the healer and the patient really want and expect the concoction to work. This has lead to a huge business in no-prescription medications and treatments. Most of which don't work. Yet, in 2008, doctors are still trying to fool you with placebos.

The placebo effect is actually a well-known phenomenon. In many clinical trials, the nontreatment group (or arm) is given a placebo medication. It's often a sugar pill or fake treatment – for example, a surgery that cuts skin but nothing more. The placebo effect is powerful. Many patients actually report improvement in symptoms.

One study gave runners tap water, but claimed it had been oxygenated. The runners given the "special" water ran faster and longer, thus proving, to many, how powerful the mind is over the body. Amazingly, almost a third of humans are susceptible to the placebo effect. Research with psychiatrists and antidepressants shows sugar pills work just as well as most prescription drugs given for depression (but that's another issue). The real problem is, no doctor can tell who those people are.

Worse than not knowing who might actually be susceptible, some doctors prescribe placebos in order to tell who really has symptoms and who is "malingering." Imagine that... a doctor lying to you to see if you're lying. How ironic.

In this recent study, doctors prescribed the placebos as "a medicine not typically used for your condition but might benefit you." If your doctor has trouble believing in your history, presentation, and diagnosis, he might give out a placebo. Chronic pain disorder fibromyalgia, for example, has long been a nemesis to many physicians because of the common belief that it is psychosomatic. Many doctors will give placebos instead of prescription pain medications.

To be fair, many U.S. doctors reported using over-the-counter headache pills and vitamins as a placebo. But in my mind, it doesn't excuse a physician from being honest and truthful. In fact, this is one of the main problems in Western medicine – the lack of trust. If my doctor doesn't know, I want him to say so. I want my doctor to do more research and get back to me, not give me a sugar pill. If my doctor thinks I have a virus and don't need an antibiotic, I want him to tell me that.

I remember my dad telling me years ago to avoid going to a surgeon for any sort of treatment until six months after an injury. Now I know why. Several studies show actual knee surgery is just as good as sham knee surgery. Worse, many doctors are uneducated about these studies in the first place.

Are you afraid yet?

When asked about the ethics of giving placebos, nearly two-thirds of doctors surveyed in the recent British Medical Journal thought it was permissible. Are you kidding me?

The health-news website HealthDay quoted one Stanford psychiatrist saying "The basic rule is: First do no harm. If there is no toxicity and it does some good, evidence supports its use... You can tell people that the treatment might benefit them."

What? How can these doctors be serious about lying because it doesn't cause any toxicity?

These doctors need to wake up and be responsible and trustworthy. I know I'll get nasty letters from doctors claiming it's OK to give placebos, but I will encourage them to pay attention to real drugs and diagnoses.

When it comes to pills, what do I do?

I look for simple, cheap, and safe things to improve the long-term quality of my life. Be careful of the doctor giving out candy.

Here's to our health,

David Eifrig Jr., M.D., M.B.A.

P.S. The health of this country is important to me too. If we can't talk honestly about issues and facts, we're no different than the doctor handing out placebos. Before you vote this week, you might find it interesting to answer the questions on issues on this website: http://www.issues2000.org. They match up your answers with presidential and congressional candidates' positions. I was shocked by the results.